Provider Demographics
NPI:1558073924
Name:TYCE, ASHLEY MICHELE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MICHELE
Last Name:TYCE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24901 CARSON LN
Mailing Address - Street 2:
Mailing Address - City:ASTATULA
Mailing Address - State:FL
Mailing Address - Zip Code:34705-9358
Mailing Address - Country:US
Mailing Address - Phone:615-491-3382
Mailing Address - Fax:
Practice Address - Street 1:600 E DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5925
Practice Address - Country:US
Practice Address - Phone:352-323-2196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily